Influenza is a viral illness also known as “the flu” that affects the respiratory system. It typically begins with the sudden onset of fever, chills, headache, and body aches. It then progresses to cause sore throat, cough, and nasal congestion. Redness of the eyes, abdominal pain, vomiting, and diarrhea can also be associated with influenza.
Influenza is spread from person to person by respiratory droplets created by coughing or sneezing. Contact with respiratory droplet-contaminated surfaces is another mode of transmission. Such surfaces include door knobs, elevator buttons, computer keyboards, and mobile devices like tablets and smartphones. Outbreaks of influenza typically begin in school aged children. This can then lead to transmission to adults, the elderly, and other children within the family.
Although the majority of children with influenza recover after about 7 days, some children even without prior medical problems can suffer serious adverse effects. Like all viral infections, influenza can weaken the immune system and make one susceptible to bacterial infections such as streptococcus and staphylococcus. These bacteria can cause co-infections such as pneumonia and sepsis – a serious sometimes life threatening bacterial infection of the blood. Influenza can also invade the tissues of the heart and cause a dangerous condition myocarditis. Finally, neurologic complications from influenza can range from febrile seizures to viral infections of the brain called encephalopathy, which can lead to permanent cognitive impairment.
While these adverse effects can affect anyone, certain groups are at higher risk from serious complications of influenza than others.
These include children under the age of 5 but especially younger than 2 years of age, pregnant women, adults over the age of 65, and those with chronic conditions like asthma, diabetes, heart problems, neurologic issues, or any major health condition.
The best preventative measure to fight against influenza and its possible complications is vaccination with the annual flu vaccine. As of the writing of this article, the level of influenza nationwide is low, but it typically begins in October and November and peaks in January. It takes about 2 weeks for the body to generate a protective immune response after vaccination, so the time for vaccination is now.
The flu vaccine is recommended for everyone 6 months of age or older but especially for those who fit the higher risk categories that were just mentioned above. Children under 9 years of age who have never received a flu shot may need two doses usually given 4 weeks apart. There are specialized versions of the flu vaccine that are meant to be given to those who are 65 years of age or older.
The flu vaccine is safe and has been shown to reduce influenza illness, doctor’s visits, trips to the emergency room, and missed work due to flu. The benefits affect all ages. A recent study showed that flu vaccine reduced children’s risk of flu related pediatric ICU admissions by 74% during the flu seasons of 2010 – 2012. Another study showed that people 50 years of age and older who received the vaccine reduced their risk of flu-related hospitalization by 57%. Finally, other studies have shown that administering the flu vaccine to pregnant women (at any stage of pregnancy) can not only be beneficial to them, but it can also reduce the infant’s risk of getting the flu for several months after birth.
A common misconception about the flu vaccine is the thought that receiving the vaccine itself can cause the flu.
This is simply not true. The vaccine is compiled using an inactivated (dead) virus, so it is not possible to contract influenza from the vaccine. The live, intranasal version of the flu vaccine has not been recommended this year by the Center for Disease Control and Prevention due to its general lack of effectiveness noted during the last 3 flu seasons. Some possible side effects from the flu vaccine include tenderness and pain from the injection site, headache, muscle aches, and chills. Fever can occur within 24 hours in 10% – 35% of children under the age of 2, but this rarely occurs in older children or adults. Generally speaking, side effects from the flu vaccine resolve within a few days.
Despite the safe and effective nature of the flu vaccine, there are a few contraindications to receiving it. As with all vaccines, if there has been a history of a severe allergic reaction – also known as an anaphylactic reaction – associated with flu vaccine, it should be avoided. Also if one has contracted the neurologic disease Guillain-Barre syndrome within 6 weeks of receiving a prior flu vaccine, one should not be vaccinated. Allergy to eggs used to be a contraindication to receiving flu vaccine, but that disqualifier has been removed recently. People with milder reactions like hives can receive the flu vaccine wherever it is available. Those with more severe reactions to eggs may need to receive the vaccine under the guidance of an allergist.
While the influenza vaccine is the most effective preventative measure to fight the flu, there are medications available that can shorten the course of the illness if one unfortunately becomes infected with the flu. Tamiflu (oseltamivir) remains an effective antiviral medication to treat people with influenza as young as 2 weeks of age. Another antiviral Relenza (zanamivir) is an inhaled medication that can be given to patients as young as 7 years of age. Administering these antivirals within 48 hours of symptoms can help to reduce the duration of fever and symptoms of influenza. They can also reduce the rate of severe complications especially in high risk patients.
There are other preventative measures that can help one stay healthy during flu season.
Frequent hand washing can help to limit exposure to germs. If soap and water are not nearby, alcohol based hand sanitizers (Purell) can be used. Avoiding close contact with those who are visibly sick can help reduce the risk of becoming sick. At the same time, staying home from work or school when you are sick can help prevent the spread of illness to other people. Covering your nose and mouth with a tissue while coughing or sneezing (or coughing/sneezing into your elbow) can also prevent those around you from becoming ill.
Also, while it can be difficult as it is second nature for a lot of us, avoid touching your eyes, nose, and mouth if possible. Germs are spread when someone touches a contaminated surface and the proceeds to touch his or her nose, eyes, or mouth. Disinfecting frequently touched surfaces at work or at school such as keyboards, desks, and door knobs can also be helpful. You may also want to think twice about touching another person’s tablet or smartphone who is visibly ill.
As always, an ounce of prevention is worth a pound of cure. Staying active, getting sufficient rest, managing stress, drinking plenty of fluids, and making healthy diet choices can go a long way to insuring a healthy and hearty holiday season.